World Mental Health Day and political pain.

It’s World Mental Health Day today, which aims to “raises public awareness about mental health issues. The day promotes open discussion of mental disorders, and investments in prevention, promotion and treatment services.” That’s a big huge umbrella, but I’d like to talk about something I’m intimately familiar with: depression.

This study found the following groups to be more likely to meet criteria for major depression:

persons 45-64 years of age

women

blacks, Hispanics, non-Hispanic persons of other races or multiple races

persons with less than a high school education

those previously married

individuals unable to work or unemployed

persons without health insurance coverage

There’s a lot of reasons for depression, and I don’t want to state that any one thing is determinative of depression, but I do want to note a couple things. One is that the psychology profession – and its pop-psych disciples who disseminate information more widely – often transcendentalise depression as an innate, biological condition. It’s an individual condition, not a structural one.

While I do of course agree that there’s biological predispositions, I think that the above list makes the point quite clearly: depression is also political. Living in a world in which you have fewer opportunities as a result of being valued less, yes that takes a mental toll. There’s no statistics there on depression among GLBT people, but as far as I know, those too suggest a greater-than-average propensity towards depression too. Facing classism, sexism, racism, homophobia, transphobia, ableism (and any combination thereof, plus I’m sure others I’m forgetting), on a day-to-day basis in everything from institutional biased policy to personal interactions, that leaves its mark. Some psychologists have a name for this process: “minority stress.”

The personal is the political has been a truism of feminism since the second wave, but we often forget what that truly means. All too frequently we create a false dichotomy between body and mind, forgetting that we are bodies and minds in space, bodies and minds in culture, bodies and minds constrained and disciplined by capitalism and the nation-state. The inequality of poverty – struggling to survive – is depressing, and as workers, most of us fundamentally alienated under capitalism, which has a continual cost it enacts upon our psyches and bodies. When my partner and I go to the pain management specialist, most of the other patients are working class men, gritting their teeth through the constant pain their professions have caused them (and this too links to mental health).

I’ve been depressed on and off for most of my life, and I’ve done all the usual treatments and some have been literally life-saving. I don’t doubt the effectiveness of psychiatric treatment or medication for some or even most people, but I do think that we should be cautious about accepting provisional political facts as unchangeable conditions. Knowing this, as I do, doesn’t mean that you can magically wave your hands and depression will go away. Knowing your depression is constructed doesn’t remove it, just as your house doesn’t disappear because you know it’s made of bricks. And it doesn’t mean that you are personally responsible for your depression if you’re not out there fighting every political fight. Nor does it mean that depression would totally disappear from the world if we somehow managed to remove all the capitalist and ideological factors I’ve discussed.

But it does mean that there are political answers (treatments, if you will) as well as medication and therapy, and I think there’s something worthwhile about naming an enemy you can fight, too.

6 Comments

This is Mental Health Day? Ha! I woke up feeling especially nervous-depressed (I’m also intimately familiar with depression) and it’s raining outside. If I hadn’t been unhealthily procrastinating by reading TBD I’d have totally missed Mental Health Day!

I may appear to be nitpicking but when you say that based on the results of the study depression is political and in that sense “constructed,” I would argue that *treatment and aggravation* of depression is political and constructed. I feel that is an extremely important distinction, in the sense that diabetes or certain cancers, also disproportionately affecting minorities, are not political or constructed, but treatment and aggravation of those conditions are. I suppose I’m extra touchy about this because of all the people in social justice movements who shoot their mouths off about how depression is “just” a symptom of what they personally believe is wrong with the world and dismiss treatment with a wave of the hand. Although from the rest of this post I can appreciate that you’re not doing this.

But that quarrel aside, thanks so much for this. The “false dichotomy of mind and body,” is such a valuable insight and a great reminder for me. As a disease that filters itself through an unjust environment, with a treatment that is so subject to human interpretation and/ or error, it’s no wonder mental health is such a bog of intersecting oppressions.

To clarify that usage of “constructed”: I mean that the mediating influence of culture helps determine the forms and intensity of depression – not that it’s an ultimate master cause that we can now control or that it wouldn’t appear in another form or another context. Depression’s definitely a complex thing to live with as we know so I want to be clear that I’m talking broad relationships and some of a multitude of factors, not HERE IS MY PRESCRIPTION NOW YOU ARE CURED, you know?

I didn’t get into treatment much here but yes, I absolutely agree that access to treatment is itself limited according to political-economic factor. Having that ability, that privilege, can make all the difference.

I think from a science perspective it’s pretty clear that mental illnesses come from both genetics and the environment – some people are genetically more susceptible, while some people live in such shitty circumstances that it would be really strange if they DIDN’T become mentally ill. For my mother it was always very important to stress that mental illness is biological, genetic, because anything else would suggest that she is to blame for her son’s schizophrenia. Growing up I learned to say “schizophrenia is genetic” in order to keep the peace, even tho I knew the truth is more complicated than that. For the past year I haven’t contacted my Mom because I couldn’t bear to tell her that I had a mental illness, but I told her about it today. Because I heard that my youngest brother, the one I used to think of as ‘normal’, was hospitalised with symptoms similar to my own, and I had to tell her that the medication that helped me might help him as well. So now all of my Mom’s 3 kids are mentally ill, and that might be because we share DNA, or because we share the same upgringing which included domestic violence… but that part is impossible to talk about, so we only mention the genetic part, like a mantra that can make it seem OK. Because the other thing was impossible to talk about, even before any of us got sick. So… really complicated. I think it’s very likely that patriarchy as expressed in domestic violence contributes to mental illness. But it’s really hard to talk about. I think the stigma of mental illness causes a huge amount of silencing.

This resonates for me. My “feminist awakening” had a huge effect on how I view my own (well-off white girl) depression, and I’ve been thinking lately about how fucked up it is that existing oppression is so easily compounded by being perceived as mentally ill.